A Fact Sheet of the African Population and Health Research Center

Women’s Lives Matter: Preventing Unsafe Abortion in Kenya

Key Findings of a National Study: Incidence and
Complications of Unsafe Abortion in Kenya

In Kenya, unsafe abortion has long been
recognized as a leading cause of death
and injury to women—deaths and injuries
that are preventable. Most abortions result
from unintended pregnancies, which, as
in most of Africa, continue to be extremely
high throughout Kenya.

A new national study undertaken in 2012
assessed the number of abortions annually
in Kenya, the extent of unsafe abortion,
the characteristics of women who seek
abortion-related care in Kenyan health
facilities and the quality of care available.
In cooperation with the Kenyan Ministry
of Health, the study was conducted in a
large representative sample of 328 public
and private health facilities across the
nation, along with a survey of 124 health
care professionals who are knowledgeable
about issues of access to abortion care.

• Nearly 465,000 induced abortions
occurred in 2012, translating to a
high national abortion rate of 48 per
1,000 women of reproductive age (15-
49 years). This rate is comparable to
Uganda’s, but much higher than other
countries in Africa or elsewhere in the
world. The rate is highest in the Rift
Valley and Nyanza/Western regions (64
and 63 per 1000 women of reproductive
age, respectively).

• More than three-quarters of
women who were treated for
post-abortion care had moderate
or severe complications, including
high fever, sepsis, shock, or organ
failure, which can require extensive
treatment or hospitalization. Delays
in seeking care and reporting to the
provider that they interfered with the
continuation of their pregnancy were
highly associated with the severity of
complications.

• Young women suffered
disproportionately, as 45% of
women aged 19 and younger who
came to a health facility for postabortion
care, experienced severe
complications.

More than
70% of women
seeking postabortion
care
were not using
a method of
contraception
prior to becoming
pregnant

• Kenya has a relatively high case-fatality rate of 266 deaths per 100,000 unsafe procedures. These deaths are almost entirely preventable. The World Health Organization (WHO) estimates the case-fatality rate in developed regions to be 30 per 100,000, compared to an estimated 460 deaths per 100,000 unsafe abortions on the African continent.

• Women who have abortions in Kenya are diverse—educated and non-educated, urban and rural, Christian and Muslim, married and unmarried, old and young.

• More than 70% of women seeking post-abortion care were not using a method of contraception prior to becoming pregnant. Similarly, the results of the most recent Demographic and Health Survey in Kenya (2008-2009) found that 43% of births in the preceding five years were reported by women as unwanted or mistimed, reflecting significant barriers to access and use of effective contraceptive methods.

• For most women reaching health facilities, methods of post-abortion care and induced abortion recommended by the World Health Organization were available and provided by trained providers. However, the continued use of methods that are not recommended—dilation and curettage (D&C) in particular—suggest that quality of care improvements are still much needed, as well as efforts to make women and communities aware that care is available and to remove barriers so that women in need of care reach facilities with minimal delays.

Conclusion

The persistence of unsafe abortion is a serious threat to the sexual and reproductive health and rights guaranteed to Kenyan women and men under the constitution enacted in 2010. Evidence from this nationally representative study should inform public dialogue and strengthen advocacy for safe abortion in Kenya, as well as delivery of safe services, within the confines of the law and in accordance with the constitution. Furthermore, improved access to comprehensive abortion care, including counseling and effective contraceptive access and use, will both save women’s lives and reduce costs to Kenya’s overburdened healthcare system.